Provider Demographics
NPI:1699976654
Name:STEVENS, DON MILTON (D C)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:MILTON
Last Name:STEVENS
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9432
Mailing Address - Country:US
Mailing Address - Phone:435-764-8976
Mailing Address - Fax:435-753-7654
Practice Address - Street 1:1300 N 200 E STE 110
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1866
Practice Address - Country:US
Practice Address - Phone:435-755-7654
Practice Address - Fax:435-753-7654
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT333250-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor